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813 -1? -0020 City of ZephyrhiUS Fie, /) 9 1 5 1 Fax- 813 - 780-0021 <br /> Permit Application _ _._. <br /> Date Received <br /> Owners Name 1 011 � C_ v I Owners Phone Number .L j r ! 1 I — c9Z I I D I I <br /> Owner's Address 1 So3 -1 l ST 7Q p.Q.‘,:•`t4 , c t -- <br /> Fee Simple Titleholder Name I I Titleholder Phone Number I I I I I <br /> Fee Simple Titleholder Address I <br /> P <br /> I Lot# I <br /> Job Address <br /> I 1 Parcel # <br /> Sub Division <br /> a Bio- Hazard Waste Storage - ANNUAL o Fumigation Tent <br /> El Comm Exhaust Kitchen Hood/Duct n Hazardous Material (tier II or RQ Facility) ANNUAL <br /> E l Controlled Bum ED Hood Installation <br /> Q Emergency Generator < 30 kw ED LP/Natural Gas - Installation <br /> Emergency Generator > 30 kw El LP/Natural Gas - ANNUAL Sale <br /> ED Fire Protection Maintenance - ANNUAL 1E1 Places of Assembly- ANNUAL <br /> Sprinkler Lj ® ®® <br /> ❑ ❑ ❑ ED Recreational Bum <br /> Fire Alarm n❑ 0 ❑ I I a spate <br /> N <br /> Hood Cleaning ❑ .`. ❑ 1 I I I Sprinlder System Installations <br /> Hood Suppression 0 O Q I I a Standpipes (Sprinkler Sys) <br /> ZI Fire Alarm Installation o Torch Roofmgrrar Kettle <br /> Are Pumps a Waste Tire Storage ANNUAL <br /> www <br /> Fire Works <br /> ..w Flammable ANNUAL I I valuation of Project <br /> 7 Fuel Tanks <br /> - ei eC Company Contractor —'iM t° . ., - • Regis ed Y / N Fee current Y / N 1 <br /> Signature Address � `11. i , = ' :l License # <br /> ELECTRICIAN Company I <br /> Signature Registered I YIN I Fee Current I Y/ N I <br /> Aar I I License* I <br /> PLUMBER I <br /> I Y N <br /> Signature Registered Y/ N I Fee Current I 1 <br /> Address I 1 License # I <br /> MECHANI CA I <br /> LF <br /> Signature I Registered Y/ N 1 Fee Current I Y/ N <br /> Address III 1 Ucense # I <br /> OTHER Company I <br /> Signature Registered L Y/ N 1 Fee Current I Y/ N 1 <br /> Address Ucense # r , m _ n, r • <br /> Directions: <br /> Fin out application completely. <br /> Owner & Contractor sign back of application. notarized (Or, copy of signed contract with owner) <br /> if over $2500. a Notice of Commencement is required (Mechanical work over 55000) <br /> Supply two (2) sets of drawings with applicable documentation <br /> Allow 10-14 days for review after submittal date. Parcel # - obtained from Property Tax Notice (Mtpifappraiser.pascogw.cmm) <br />